Prevalence of falls in hyponatraemic patients presenting to an emergency department

Abstract

Introduction Hyponatraemia is the most common electrolyte disturbance and is caused by either salt and water loss or water retention. The condition has been associated with gait disturbances and falls. We undertook a clinical audit of emergency presentations by patients with hyponatraemia. Methods All emergency presentations to a tertiary level hospital who had an initial plasma electrolyte evaluation with a Na 129 mmol/L were selected. Plasma osmolality, K, Cl, emergency and discharge diagnosis for each patient were collated. Results During January-August 2009, 375 specimens (from 300 patients) with Na ≤ 129 mmol/L were received from the emergency department (ED). Only 59 specimens had an osmolality requested (16%). Forty-one of 300 patients presented to ED with a history of recurrent falls (13.7%) of whom 18 (43.9%) sustained a fracture as a result of the fall. The mean plasma Na in the fracture patients was 126 (120–129 mmol/L) similar to the mean for all patients with falls (125.7, range 119–129 mmol/L; mean age 81, range 55–96 years) but less than age matched controls (p Discussion The incidence of hyponatraemia in patients with fractures has been reported to be higher than other patients presenting to ED. Falls and fractures occur in patients with mild to moderate hyponatraemia, suggesting the need for careful follow up of Na levels in the elderly.